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The epidemiological transition: need to incorporate obesity prevention into nutrition programmes

Published online by Cambridge University Press:  22 December 2006

Ricardo Uauy  and
Juliana Kain
Ricardo Uauy*
Affiliation:
Institute of Nutrition and Food Technology (INTA), University of Chile, Casilla 138-11, Santiago, Chile
Juliana Kain
Affiliation:
Institute of Nutrition and Food Technology (INTA), University of Chile, Casilla 138-11, Santiago, Chile
*
*Corresponding author: Email [email protected]
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Abstract

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Background:

Trends in the nutritional status for developing countries that are undergoing rapid economic growth indicate a decrease in protein-energy malnutrition (PEM) with an associated rise in obesity prevalence.

Objective:

This paper analyses how supplementary feeding programmes may contribute to rising obesity trends, what factors may explain this phenomenon, and potential strategies to avoid obesity in malnutrition prevention efforts.

Design and setting: This is a descriptive study of changes in nutritional status of infants and young children in Chile and the possible impact of supplementary feeding programmes on the rise in prevalence of obesity. We explored the changes in anthropometric indices before and after receiving food programme benefits and the use of targeting strategies as a way to combine the need to promote optimal growth while preventing obesity.

Results:

Evaluation of the change in nutritional status from participants in Chilean supplementary feeding programmes has shown that targeting strategies have been inadequate as children mainly modify their weight-for-age and weight-for-height, while their length-for-age remains practically unchanged.

Conclusions:

Monitoring length-for-age as well as weight-for-length is necessary to permit the identification of stunted overweight and obese children, as they should not be given excess energy. Energy supplementation should be adjusted according to activity level, securing adequate micronutrient density. PEM prevention programmes need periodic evaluation, including targeting of beneficiaries, definition of real needs and possible effect on obesity.

Keywords

Epidemiological transitionNutrition programmesStuntingWastingUnderweightObesity
Type
Research Article
Information
Public Health Nutrition , Volume 5 , Issue 1a , February 2002 , pp. 223 - 229
Copyright
Copyright © CABI Publishing 2002

References

1Popkin, BM. The nutrition transition and its health implications in lower-income countries. Public Health Nutr. 1998; 1: 5–22.CrossRefGoogle ScholarPubMed
2Uauy, R, Albala, C, Kain, J. Obesity trends in Latin America: transiting from under to overweight. J. Nutr. 2001; 131: 893S–99S.CrossRefGoogle ScholarPubMed
3Martorell, R. Results and implications of the INCAP Follow-up Study. J. Nutr. 1995; 125: 1127S–38S.Google ScholarPubMed
4Peña, M, Bacallao, J. Obesity among the poor: an emerging problem in Latin America and The Caribbean. In: Peña, M, Bacallao, J, eds. Obesity and Poverty. A New Public Health Change. Scientific Publication No. 576. Washington, DC: Pan American Health Organization, 2000.Google Scholar
5Albala, C, Vio, F. Epidemiological transition in Latin America: the case of Chile. Public Health 1995; 109: 431–42.CrossRefGoogle ScholarPubMed
6Administrative Committee on Coordination Sub-committee on Nutrition (ACC/SCN) and International Food Policy Research Institute (IFPRI). 4th Report on the World Nutrition Situation. Geneva: ACC/SCN, January 2000.Google Scholar
7Albala, C, Vio, F, Kain, J, Uauy, R. Nutrition transition in Latinamerica: the case of Chile. Nutr. Rev. 2001; 59: 170–6.CrossRefGoogle Scholar
8Kain, J, Burrows, R, Uauy, R. Obesity trends in Chilean children and adolescents. In: Obesity in Childhood and Adolescence. Nestlé Nutrition Workshop Series [in press].Google Scholar
9Chilean Ministry of Health. Manual of the National Supplementary Feeding Program (PNAC). Santiago: Chilean Ministry of Health, 1988.Google Scholar
10Kain, J, Vial, I, Muchnik, E, Contreras, A. An evaluation of the enhanced Chilean Supplementary Feeding Program. Arch. Latinoam. Nutr. 1994; 44: 242–50.Google Scholar
11Kain, J, Uauy, R. Targeting strategies used by the Chilean National Supplementary Feeding Program. Nutr. Res. 2001; 21: 677–88.CrossRefGoogle Scholar
12Kain, J, Pizarro, F. Effect of an enhanced supplementary feeding program on infants length. Arch. Latinoam. Nutr. 1997; 47: 101–4.Google Scholar
13Chilean Ministry of Health. Manejo Ambulatorio del Niño con Malnutrición. Santiago: División Programa de las Personas, 1994.Google Scholar
14Torche, A, Muchnik, E, Atalah, C, Vial, I. Study of the Economic Evaluation of the National Supplementary Feeding Program. Final Report to the Ministry of Health, Santiago, 1995.Google Scholar
15Uauy, R, Riumallo, J. Work Plan in Support of Guidelines on Formulating and Implementing Nutrition Programs (FINP) at the Country Level: Case Study. Chile: Food and Agriculture Organization, 1997.Google Scholar
16Cardona, O, Salazar, G, Díaz, E. Medición del gasto energético y patrón de actividad física de los niños asistentes a JUNJI. Tesis para optar al Grado de Magíster en Nutrición Humana INTA, Santiago, 2001.Google Scholar
17Rebolledo, A, Atalah, E, Herrera, P, Araya, H, Castillo, C. Hábitos alimentarios de preescolares de INTEGRA. Rev. Chil. Nutr. 1996; 24: 43.Google Scholar
18Kain, J, Andrade, M. Characteristics of the diet and patterns of physical activity in obese Chilean preschoolers. Nutr. Res. 1999; 19: 203–15.CrossRefGoogle Scholar
19Schroeder, D, Martorell, R. Fatness and body mass index from birth to young adulthood in a rural Guatemalan population. Am. J. Clin. Nutr. 1999; 70(Suppl.): 137S–44S.CrossRefGoogle Scholar
20Trowbridge, FL, Marks, JS, Lopez de Romana, G, Madrid, S, et al. Body composition of Peruvian children with short stature and high weight-height. II. Implications for the interpretation for weight for height as an indicator of nutritional status. Am. J. Clin. Nutr. 1987; 46: 411–8.CrossRefGoogle Scholar
21Hoffman, D, Sawaya, A, Verreschi, I, Tucker, K, Roberts, S. Why are nutritionally stunted children at increased risk of obesity? Studies of metabolic rate and fat oxidation in shantytown children from Sao Paulo, Brazil. Am. J. Clin. Nutr. 2000; 72: 702–7.CrossRefGoogle ScholarPubMed
22Kain, J, Uauy, R, Díaz, M, Aburto, A. Height increases in schoolchildren entering first grade during the last decade. Rev. Med. Chil. 1999; 127: 539–46.Google ScholarPubMed
23Bellizzi, M, Dietz, W. Workshop on childhood obesity: summary of the discussion. Am. J. Clin. Nutr. 1999; 70: 173S–5S.CrossRefGoogle ScholarPubMed
24Abala, C, Vio, F, Kain, J, Uauy, R. Nutrition transition in Chile: determinants and consequences. Public Health Nutr. 2002; 5 123–8.CrossRefGoogle Scholar
25Martorell, R, Kettel-Khan, L, Schroeder, D. Reversibility of stunting: epidemiological findings in children from developing countries. In: Causes and Mechanisms of Linear Growth Retardation [special issue]. Eur. J. Clin. Nutr. 1993: 48; S45–S57.Google Scholar
26Karlberg, J, Jalil, F, Lam, B, Low, L, Yeung, C. Linear growth retardation in relation to three phases of growth. In: Causes and Mechanisms of Linear Growth Retardation [special issue]. Eur. J. Clin. Nutr. 1993; 48: S25–S44.Google Scholar
27Golden, MHN. The role of individual nutrient deficiencies in growth retardation of children, as exemplified by zinc and protein. In: Waterlow, JC, ed. Linear Growth Retardation in Less Developed Countries. Vevey: Nestlé Nutrition/New York: Raven Press, 1988; 143–64.Google Scholar
28Rojas, J, Uauy, R. Need to prevent obesity without neglecting the protection of children at risk of malnutrition. Rev. Chil. Nutr. 1999; 26: 35–39.Google Scholar